The revised NWLRC fat intake scale: A quick way to assess cholesterol-lowering diets

Abstract

Two years ago, we reported on the validity, reporducibility, and ability of a short questionnaire, the FIS, to assess intake and changes in dietary fat among men on cholesterol-lowering diets. We now report on an updated version (FIS2) that incorporates additional information on the effect of diet on lipids. The FIS2 contains 12 questions concerning the quantity or type of fat containing foods usually eaten. The score, obtained by adding the 12 responses, can range from 12 to 44. When used in a worksite cholesterol screening of over 7000 employees, it proved to be a quick, efficient, inexpensive way to estimate intake of cholesterol-raising dietary components. When dietitians interviewed persons with low scores on the phone, the questions were a useful guide to estimate if an individual was following the guidelines for a cholesterol-lowering diet. Correlations between each of the 12 questions and the total score were highly significant, with responses to summary questions about the fat content of food eaten at home and away from home having higher correlations than did the specific food groups. A subset of hypercholesterolemic adults, 248 men and 119 women, repeated the questionnaire along with a 4-day food record. Correlations between the scale score and nutrients the scale was predicted to assess were: grams of total fat (.51), g saturated fat (.53), g monounsaturated fat (.49), % calories from total (.43), saturated (.42), and monounsaturated (.41) fat, Key's score (.41) and mg cholesterol (.46). Correlations were lower, .07 to .21, for selected nutrients the scale was not intended to assess. In general, correlations were slightly higher for the updated 12 item questionnaire than for the previous 9 item version. This tool provides a quick, cost effective way to assess diet. It is also useful to guide counseling and goal setting for cholesterol-lowering diets.